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Get Vcs Patriot Plus Card Application

fully understand that personal identifying information of the nature described above may be disclosed to collect a valid debt. I expressly agree to the cited terms and conditions of this Agreement. Customer Signature:_______________________________________________ _______________________________________________ VCS Authorizing Official Signature/Date ________________________________________ VA Payroll Verified Eligible By/Date **Applicant should receive a copy of agreement upon signature. **O.

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